Screening guidelines

Question 1

Breast cancer screening guidelines (CTFPHC and Qc)?

Answer 1

CTFPHC:
- 40 to 49 = not screen (conditional)
- 50 to 69 = mammo q 2 years (conditional)

Qc: The PQDCS invites women aged 50 to 69 to have a mammogram every 2 years.

Question 2

Cervical cancer screening guidelines (CTFPHC and Qc)?

Answer 2

CTFPHC:
- 25 to 29 pap q 3 years (weak)
- 30 to 69 pap q 3 years (strong)
- 70 and plus, if no 3 consecutive negative pap, continue this is the case

Qc: Women between the ages of 21 and 65 should have a Pap test every 2 to 3 years.

Question 3

Ovarian cancer screening guidelines (CTFPHC)?

Answer 3

No screening if Asx.

Question 4

Prostate cancer screening guidelines (CTFPHC)?

Answer 4

• no screening men less 55 years old (strong)
• 55-69 = no screening (weak)
• 70 and older = no screening (strong)
  Screening with prostate-specific antigen

Question 5

Colorectal cancer screening guidelines (CTFPHC)?

Answer 5

• 50 to 74 = FIT test q 2 years

Question 6

Lung cancer screening (CTFPHC)?

Answer 6

• 55 to 74 with 30 pack-year or quit less than 15 years ago = low dose computed tomography q year for 3 consecutive years

Question 7

AAA screening (CTFPHC)?

Answer 7

-One-time screening ultrasound, men 65-80 (weak)
-Not screen men aged 80 and plus
-Not screen women (strong)

Question 8

Depression screening (CTFPHC)?

Answer 8

not routinely screen (weak)

Question 9

Lipid disorder screening?

Answer 9

Older 40 years old, or anyone with a condition (long list, includes smoking) whatever the age.

Question 10

Osteoporosis screening (developed by osteoporosis Canada in 2010 and approved with limitation by CTFPHC in 2013)?

Answer 10

Bone Mass Density testing:

• Age < 50 yo: Fragility fracture, use of high-risk medication, etc
• Age 50-64: Add prolonged use of glucocorticoid, parental hip fracture, high ETOH or current smoking
• Age 65 and plus: Everyone

Question 11

COPD screening?

Answer 11

USPSTF: No screening unless Sx which are: dyspnea, chronic cough, sputum production.
GOLD report: Screen with spirometry if significant exposure to tobacco (>20 pack-year) or recurrent lung infection.

Question 12

Type 2 Db (diabetes Canada)?

Answer 12

Use FINDRISK to assess level of risk
Who to screen?
1: Below 40 yo or low-moderate risk factors = assess risk factor q year
2: 40 and above or younger with high-risk factor = HbA1c q 3 years + assess risk factors q year
3: If very-high risk = Screen q 6-12 months whatever the age.

Risk factors (not exhaustive):
- First degree-relative with Db type 2
- Member of high-risk pop: non-white and low socioeconomic status
- History of preDb/GDM
- Presence of vascular risk factors: Dyslipidemia, HTN, Overweight, Abdominal obesity, Smoking
- presence of end organ damage

Question 13

HTN (CTFPHC)?

Answer 13

• Take BP all primary care visits

Question 14

Dyslipidemia (Canadian cardiovascular society)?

Answer 14

Screening: standard lipid profile, etc
1. Screen men/women above age 40, and postmenopausal women.
2. All pt with following regardless of age: Db, current cig. smoking, xanthelasma/xanthoma, obesity BMI above 30, family history of dyslipidemia/CVD, erectile dysfunction, COPD, preeclampsia/eclampsia

Question 15

Pack-year?

Answer 15

One pack-year is smoking 20 cigarettes a day for one year.